| The role of humoral and cellular immune factors in neuromuscular block in myasthenia gravis. | |
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MedLine Citation:
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PMID: 786115 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The neuromuscular block of myasthenia gravis appears to be due to decreased and abnormal responsiveness of the motor end plates to transmitter, and perhaps a decreased number of functioning end plates. The presence in myasthenic patients of serum globulins that bind to a bariety of cellular and subcellular components, and of thymic abnormalities, has encourage the search for humoral and cellular immune factors that may be responsible for the anatomic and functional defects. Attempts to demonstrate neuromuscular blocking activity in the serum have been inconclusive. While 30% to 48% of myasthenic patients have globulins that react with muscle membrane, striations, ribonucleporotein, and thymic epithelial cells, these globulins have not been shown to react with the end plate or acetylcholine receptor, or to impair neuromuscular transmission. Antinuclear, rheumatoid, antimitochondrial antithyroid, anti-smooth-muscle, and anti-gastric-parietal cell factors are found in the serum of 3% to 16% of myasthenic patients, but these are much more commonly present in other diseases. However, antibodies to acetylcholine receptor from electric tissue, which were recently reported in the serum of three fourths of myasthenic patients, may prove to be more directly related to the neuromuscular block. While the majority of myasthenic patients have thymic abnormalities, including thymoma in 9% of patients and hyperplastic thymus in 66% of patients, the remaining 25% of patients have normal, involuted, or undetectable thymus. Thymectomy has a favorable effect in about two thirds of myasthenic patients, but about one third of patients have no benefit. Thirty-two patients have been described who developed myasthenia gravis after total thymectomy and presumably in the absence of the thymus. Thymus lymphocytes of myasthenic patients have some differences from those of normal subjects, including a greater proportion of B cells, but their significance is not known. Attempts to demonstrate neuromuscular blocking activity in the thymus of myasthenic patients have been inconclusive. Blood lymphocytes of myasthenic patients also have some differences from those of normal subjects, including a lower proportion of T cells. The proportion of both T and B cells increased following thymectomy. While studies on the immunological reactivity of lymphocytes from myasthenic patients have shown some differences from those of normal subjects, neuromuscular blocking activity has not been demonstrated in these cells or in their extracts. There is increasing evidence that the neuromuscular block of myasthenia gravis is due to alteration of the acetylcholine receptor. The recent reports of antibodies to acetylcholine receptor in the serum of myasthenic patients suggests that these may be responsible for the neuromuscular block, but such action, and the cause of antibody release, remain to be determined. |
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Authors:
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T Namba; Y Nakata; D Grob |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Annals of the New York Academy of Sciences Volume: 274 ISSN: 0077-8923 ISO Abbreviation: Ann. N. Y. Acad. Sci. Publication Date: 1976 |
Date Detail:
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Created Date: 1976-10-20 Completed Date: 1976-10-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7506858 Medline TA: Ann N Y Acad Sci Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 493-515 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals B-Lymphocytes / physiology Humans Immunity* Immunity, Cellular* Lymphocyte Activation Membranes / immunology Muscles / immunology Myasthenia Gravis / blood, complications, immunology*, physiopathology Neuromuscular Junction / immunology*, physiopathology Serum Globulins / immunology T-Lymphocytes / physiology Thymoma / complications, immunology Thymus Extracts / pharmacology Thymus Gland / physiopathology Thymus Hyperplasia / immunology Thymus Neoplasms / complications, immunology |
| Chemical | |
Reg. No./Substance:
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0/Serum Globulins; 0/Thymus Extracts |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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